Basic Information
Provider Information
NPI: 1306297627
EntityType: 2
ReplacementNPI:  
OrganizationName: HAND AND ORTHOPEDIC CENTER OF SOUTHERN CALIFORNIA, INC.
LastName:  
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Mailing Information
Address1: PO BOX 1007
Address2:  
City: MURRIETA
State: CA
PostalCode: 925641007
CountryCode: US
TelephoneNumber: 9517193330
FaxNumber:  
Practice Location
Address1: 8555 FLORENCE AVE
Address2:  
City: DOWNEY
State: CA
PostalCode: 902404014
CountryCode: US
TelephoneNumber: 5629239351
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/28/2016
LastUpdateDate: 06/28/2016
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: CAPUTO
AuthorizedOfficialFirstName: ROY
AuthorizedOfficialMiddleName: JOHN
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 7144032483
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XH1200XG57575CAY193400000X SINGLE SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand

No ID Information.


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